The burden of perineo-gluteal hidradenitis suppurativa on patients’ quality of life: A Moroccan study

Perineo-gluteal hidradenitis suppurativa (HS) is a severe and disabling form of HS due to its painful lesions, anatomical location, and impact on daily activities. This study aimed to evaluate its effect on patients’ quality of life in a Moroccan population, while accounting for cultural factors. A retrospective cohort with prospective cross-sectional analysis was conducted at our dermatology department. Patients with perineo-gluteal HS who had been followed since 2012 were contacted between 2022 and 2024. Quality of life was assessed using the Arabic version of the Dermatology Life Quality Index (DLQI), along with psychological evaluations: Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale, and Body Image Questionnaire (BIQ). Out of 60 patients with HS, 51 (85%) had perineo-gluteal involvement. Chronic smoking and prolonged sitting were frequent aggravating factors. The mean DLQI score was 11.5, indicating a very large impact on quality of life. Depression was found in 50% of patients, low self-esteem in 66.6%, and negative body image in 61%. Nearly 59% avoided hammams and had difficulty performing ablutions; 9.8% used diapers due to incontinence. Higher DLQI scores were significantly associated with disease severity and smoking. Perineo-gluteal HS severely affects patients’ physical, psychological, and social well-being. Its intimate location, combined with pain and cultural constraints, contributes to a profound quality-of-life burden. Effective care requires a multidisciplinary, culturally sensitive approach tailored to this challenging HS presentation.